Health 101: Infertility in Women

If you've been struggling to get pregnant, you've probably got lots of questions. Here, find out what causes infertility, how to reduce your risk, when to see a doctor, potential infertility treatments, and more.

What is infertility?

Infertility is a medical condition in which a couple is unable to conceive a baby. Experts don't consider a couple to have fertility problems until they've been actively trying to get pregnant for at least one year, or if the woman is older than 35, for more than six months. Some couples who experience recurrent miscarriages may also be considered infertile and should seek help from their doctor or a fertility expert.

Experiencing infertility, though, doesn't mean you won't ever have a baby. For some couples, it just takes longer; for others, it may require drugs, surgery, or high-tech help. Take heart in the following stats from the Mayo Clinic:

  • After 12 months of unprotected sex, about 85 percent of couples will get pregnant.
  • Of the remaining 15 percent, about half will get pregnant over the next three years, using methods like medications, surgery, assisted reproductive technology, or even naturally.

According to other research, about two-thirds of all couples who seek treatment for fertility problems are able to have a baby eventually.

Are men or women more likely to experience infertility?

It's pretty much an even split, despite persistent misconceptions that infertility is a "woman's problem." About one-third of cases are due to women's health issues, another third are due to men's health issues, and the rest of the time, it's either a mix of both partners' conditions or unknown causes.

What causes infertility in women?

Making a baby is a complex process that's contingent upon four crucial steps:

  • A woman and man each producing eggs and sperm
  • Healthy fallopian tubes that allow the sperm to easily get to the egg
  • Sperm's ability to fertilize the egg upon reaching it
  • A fertilized egg's ability to attach to the uterus and continue developing normally

Infertility may result when there's a hiccup in one or more of these steps. Because conception is so complicated, there are a number of factors that can lead to infertility in women:

 

Fallopian tube damage is the primary cause of infertility in women, occurring in about 30 percent of cases. If your fallopian tubes are scarred or blocked, sperm may have difficulty reaching your egg, or your fertilized egg may not be able to safely travel to your uterus to develop into a healthy baby. Having very painful periods or a history of pelvic pain are common signs of fallopian tube damage.

Fallopian tubes may become blocked or damaged in a few ways. Often, it's from an infection called pelvic inflammatory disease, which usually results when sexually transmitted diseases like chlamydia and gonorrhea go untreated (they're easily curable with antibiotics).

Another cause is endometriosis, a condition where the tissue that normally lines the uterus starts growing where it shouldn't -- like in the fallopian tubes, ovaries, or other nearby organs. If this tissue blocks openings in the ovaries or fallopian tubes, it can prevent an egg from being released or fertilized.

In rarer cases, fallopian tube damage may be due to having a prior ectopic pregnancy (where the fertilized egg implants outside of the uterus). Ectopic pregnancies are very dangerous for moms-to-be; because they need to be terminated as soon as possible, they don't result in live births.

Ovulation problems occur about 20 percent of the time. If you don't ovulate normally, then you're not releasing healthy eggs for sperm to fertilize. The main symptoms of ovulation roadblocks are irregular or missing periods.

Ovulation problems usually result from hormonal imbalances. The female sex hormones LH, FSH, and estrogen are the big ones needed to launch an egg each menstrual cycle -- if they're released at the wrong time or in the wrong amounts, it can throw off ovulation. Weighing too much or too little can also mess with your hormones and hinder ovulation.

Up to 10 percent of all women experience a condition called polycystic ovarian syndrome (PCOS), where a hormone imbalance triggers the body to produce excess testosterone, which can also hinder ovulation. Women with PCOS may be overweight and have excess body or facial hair and acne, in addition to irregular or missing periods.

Problems with the uterus occur about 20 percent of the time. If your egg can't attach normally to the wall of the uterus, it can't continue developing into a healthy fetus. Unexplained lower-abdominal pain or bloating may be a sign of uterine problems that can affect fertility. This may be due to fibroids or polyps, which are benign tissue growths from the wall of the uterus; they may sometimes affect fertility depending on their size and location. Scar tissue in the uterus from infection, miscarriage, or abortion may also play a role.

The remaining causes of infertility in women may include immune system diseases, kidney disease and diabetes, early menopause, cancer and treatment for it (like chemotherapy and radiation), or taking certain medications (some drugs that treat blood pressure, depression, or asthma, for example, may impact fertility).

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